Highlights

•NeuroTouch, the most realistic simulators for neurosurgery available to date, has been used to evaluate performance changes after sleep interruption.

•In our study we could find an increase of neurosurgical simulator performance in neurosurgical residents and medical students under simulated night shift conditions.

Abstract

Objective

In times of the ubiquitous debate about doctors’ working hour restrictions, it is still questionable if the physician’s performance is impaired by high workload and long shifts.

In this study we evaluated the impact of sleep interruption on the neurosurgical performance.

Methods

Ten medical students and ten neurosurgical residents were tested on the virtual-reality simulator NeuroTouch by performing the identical microsurgical task, well-rested (baseline test), and after sleep interruption at night (stress test). Deviation of total score, timing and excessive force on tissue were evaluated. Additionally, vital parameters and self-assessment were analyzed.

Results

After sleep interruption, total performance score increased significantly (45.1 vs. 48.7, baseline vs. stress test, P = .048) while timing remained stable (10.1 vs. 10.4 minutes for baseline vs. stress test, P > .05) for both students and residents. Excessive force decreased in both groups during stress test for the non-dominant hand (P = .05). For the dominant hand, an increase of excessive force was encountered in the group of residents (P = .05). In contrast to their actual results, participants of both groups assessed their performance worse during stress test.

Conclusion

In our study we could find an increase of neurosurgical simulator performance in neurosurgical residents and medical students under simulated night shift conditions. Further, microsurgical dexterity remained unchanged.Based on our results and the data in the currently available literature we cannot confirm that working hour restrictions will have a positive effect on neurosurgical performance.